Best Practices of Medical Device Reprocessing

Healthcare Associated Infections (HAI’s) are the most common complication affecting patients in Hospitals. Patient safety and best practice start in the CSSD. Many SSIs can be prevented with practices that help mitigate the numerous risk factors contributed by the patient or the environment. A surgical care process provides a systematic approach to support implementation of evidence-based, effective strategies to manage modifiable risk factors and improve surgical outcomes.

Cleaning & Disinfection

CDC Recommends:

Use cleaning agents that are capable of removing visible organic and inorganic residues.

Clean medical devices as soon as practical after use because soiled materials become dried onto the instruments.

Testing should be performed to assess efficacy of cleaning of medical devices.

Sterilisation & Monitoring

CDC Recommends:

Use mechanical, chemical and biologic monitors to ensure the effectiveness of the sterilisation process.

AAMI Recommends:

A biological indicator (BI) within a process challenge device (PCD) should be used for weekly*, preferably daily routine efficacy testing and in every load containing implants. Loads containing implants should be quarantined until the BI results are known.

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3M Sterilisation - Assurance at Every Step

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Collaborating for Patient Safety - Infection Preventionists and CSSD

The role of Infection Preventionists in the CSSD is to "Conduct infection control rounds periodically in high-risk reprocessing areas and ensure reprocessing instructions are current and accurate and are correctly implemented. Document all deviations from policy. All stakeholders should identify what corrective actions will be implemented."

Performing a risk analysis in CSSD

In a CSSD department, there are numerous risks such as improper cleaning, steriliser loading, cycle selection, or even a steriliser malfunction. Extended steam sterilisation cycles still trouble many CSSDs, as do loaner sets. The decontamination process is constantly becoming more difficult. A CSSD is faced with instrumentation that is difficult to clean because of long narrow lumens, intricate designs, inaccessible lumens and new materials. In CSSD a risk analysis should be performed to prevent infections and enhance patient safety.